What is the most common cause of peptic ulcers?

Appeared in: NORCET 1 - 2020

Explanation

Helicobacter pylori (H. pylori) infection is the leading cause of peptic ulcer disease, responsible for the majority of cases.
This bacterium damages the protective mucous lining of the stomach and duodenum, allowing stomach acid to create sores or ulcers.
The second most common cause is the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Treatment for H. pylori-associated ulcers involves a combination of antibiotics and acid-suppressing medications to eradicate the bacteria and allow the ulcer to heal.

Option A: While severe physiological stress (e.g., from major surgery or trauma) can cause acute 'stress ulcers', chronic psychological stress is not a direct cause of peptic ulcers.
Option B: Spicy foods do not cause ulcers, although they can irritate an existing ulcer and worsen symptoms like abdominal pain.
Option D: Smoking is a significant risk factor, not a primary cause. It impairs ulcer healing, increases the risk of recurrence, and can increase stomach acid production.

Visual 1: Diagram: Illustration showing H. pylori bacteria in the stomach lining, leading to the breakdown of the mucosal layer and ulcer formation.
Visual 2: Infographic: Comparison chart of Gastric vs. Duodenal ulcers, highlighting key differences in location, pain patterns, and relation to meals.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Peptic Ulcer Disease as background academic context rather than a clinical decision trigger.
Nurses must educate patients that peptic ulcers are often caused by a treatable infection, not just lifestyle choices, to reduce stigma and improve treatment adherence.
A key nursing role is to assess for H. pylori risk factors and NSAID use in patients presenting with epigastric pain.
What if? If a patient has symptoms of a peptic ulcer but tests negative for H. pylori, the nurse's next priority is to investigate the patient's use of NSAIDs, including over-the-counter medications like ibuprofen or aspirin, as this is the second most common cause.

How to Approach the Question

Identify the core of the question: It asks for the 'most common cause' of peptic ulcers.
Recall the primary etiologies of Peptic Ulcer Disease (PUD). The two main causes are H. pylori infection and NSAID use.
Evaluate the given options against this knowledge. 'H. pylori infection' is listed as an option.
Differentiate between primary causes and risk/exacerbating factors. Stress, spicy food, and smoking are risk factors, but not the most common primary cause.
Select the option that represents the leading cause, which is H. pylori.

Concept Tested & Keywords

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Practise the full NORCET 1 - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.